Andrew WinnardSpace Medicine Systematic Review Expert
Andrew Winnard
Doctor of Philosophy
Supporting global space medicine systematic reviews with the latest up to date methods.
About
59
Publications
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269
Citations
Introduction
My main field of work is in space medicine systematic reviews, conducting them and developing methods to improve the quality of synthesis across the space medicine sector. The reviews aim to positively impact space medicine operations, identify research gaps for experimental work and drive important political messages in the field. To acomplish this I lead a Space Biomedicine Systematic Review Group. Find the most up to date review methods at: www.SpaceMed-SR.vze.com
Publications
Publications (59)
Background: Space Agencies are planning human missions beyond Low Earth Orbit. Consideration of how physiological system adaptation with microgravity (μG) will be managed during these mission scenarios is required. Exercise countermeasures (CM) could be used more sparingly to decrease limited resource costs, including periods of no exercise. This s...
Background
The constraints of the Orion Multi-Purpose Crew Vehicle present challenges to the use of current exercise countermeasures necessary to prevent severe deconditioning of physiological systems during microgravity exposure beyond Low Earth Orbit. The purpose of this qualitative systematic review was to determine the technical constraints of...
Andrew Winnard has been leading systematic review methods for space medicine projects many years to facilitate high quality and transparent synthesis of primary data to enable evidence-based practice. You can find the most up to date methods here: https://sites.google.com/view/sr-methods/home This paper outlines evolution of space medicine synthesi...
This is a presentation that introduces the basics of conducting a systematic review in space medicine areas. It was created by Dr Andrew Winnard who is an international expert in space medicine systematic review methods, along with Dr Tobias Webber and Dr David Green, who are experts in operational space medicine research based at the European Astr...
Background: The recent discovery of a venous thrombosis in the internal jugular vein of an astronaut has highlighted the need to predict the risk of venous thromboembolism in otherwise healthy individuals (VTE) in space. Virchow’s triad defines the three classic risk factors for VTE: blood stasis, hypercoagulability, and endothelial disruption/dysf...
![Fig. 1. PRISMA flow diagram [32].](profile/Patrick-Swain-2/publication/362360699/figure/fig1/AS:1185688976392194@1659701689199/PRISMA-flow-diagram-32_Q320.jpg)
Space agencies are planning to send humans back to the Lunar surface, in preparation for crewed exploration of Mars. However, the effect of hypogravity on human skeletal muscle is largely unknown. A recently established rodent partial weight-bearing model has been employed to mimic various levels of hypogravity loading and may provide valuable insi...
Space agencies are preparing to send humans to the Moon (16% Earth's gravity) and Mars (38% Earth's gravity), however, there is limited evidence regarding the effects of hypogravity on the skeletal system. A novel rodent partial weight-bearing (PWB) model may provide insight into how human bone responds to hypogravity. The aim of this study was to...
Reduced muscle size and accumulation of paraspinal muscle fat content (PFC) have been reported in lumbopelvic muscles after spaceflights and head-down tilt (HDT) bed rest. While some information is available regarding reconditioning programs on muscle atrophy recovery, the effects on the accumulation of PFC are unknown. Recently, a device (the Func...
Exposure to spaceflight and head-down tilt (HDT) bed rest leads to decreases in the mass of the gluteal muscle. Preliminary results have suggested that interventions, such as artificial gravity (AG), can partially mitigate some of the physiological adaptations induced by HDT bed rest. However, its effect on the gluteal muscles is currently unknown....
BACKGROUND CONTEXT
Prolonged bedrest induces accumulation of intramuscular lipid concentration (ILC) in the lumbar musculature; however, spatial distribution of ILC has not been determined. Artificial gravity (AG) mitigates some adaptations induced by 60-day bedrest by creating a head-to-feet force while participants are in a supine position.
PURP...
Background
The rodent partial weight-bearing (PWB) model has been recently developed to enable full-body partial unloading of mice [1] and rats [2] whilst maintaining their ability to ambulate in a cage setting. The model has expanded understanding of how the musculoskeletal system adapts to various levels of PWB across the ‘gravity continuum’ [3]....
This is a duplicate record, please see https://www.researchgate.net/publication/350278122_Developing_and_implementing_novel_techniques_during_primary_space_medicine_data_systematic_reviews for the original record. Andrew Winnard has been leading systematic review methods for space medicine projects many years to facilitate high quality and transpar...
Methods handbook from the space biomedicine systematic review website. Covers quant and qual methods, prescoping, searching, quality scoring and analysis. For full guidance and all the methods guides visit the site at spacemed-sr.vze.com/
This study investigated whether artificial gravity (AG), induced by short-radius centrifugation, mitigated deterioration in standing balance and anticipatory postural adjustments (APAs) of trunk muscles following 60-day head-down tilt bed rest. Twenty-four participants were allocated to one of three groups: control group (N=8); 30 minutes continuou...
Exposure to axial unloading induces adaptations in paraspinal muscles, as shown after spaceflights. This study investigated whether daily exposure to artificial gravity (AG) mitigated lumbar spine flattening and muscle atrophy associated with 60-day head-down tilt (HDT) bed rest (Earth-based space analogue). Twenty-four healthy individuals particip...
Background Exercise countermeasures are the main approach taken to protect astronauts from musculoskeletal deconditioning in microgravity (µg). Future exploration class missions will require astronauts to live on the surface of the Moon (0.16g) and Mars (0.38g) in hypogravity where the level of protection is assumed to be insufficient. However, it...
Introduction
The ageing process can result in the decrease of respiratory muscle strength and consequently increased work of breathing and associated breathlessness during activities of daily living in older adults. This systematic review and meta-analysis aims to determine the effects of inspiratory muscle training (IMT) in healthy older adults gi...
Background
The ageing process can result in the decrease of respiratory muscle strength and consequently increased work of breathing and associated breathlessness during activities of daily living in older adults.
Objective
This systematic review and meta-analysis aims to determine the effects of inspiratory muscle training (IMT) in healthy older...
Find the most up to date version here: https://sites.google.com/view/sr-methods/home
This form can be used as is, or as a guide for your own form. It is based on the forms used by Cochrane Groups, so conforms to high standards from medical research. You should have already completed a question refinement form before making a protocol. The protocol...
Detrimental health effects from ionizing radiation to living organisms is one of the key concerns identified and addressed by Radiation Protection institutions, nationally and internationally on Earth and for human spaceflight. Thus, new methods for mitigating the adverse effects of ionizing radiation are urgently needed for terrestrial health and...
This process is intended to guide potential reviewers through the basic process of using NVivo for integrative or qualitative systematic reviews. The aim is to help you understand how to use NVivo to manage your qualitative data, visually present that data and support you in the writing of your report.
Please cite this tool as: Laws, J.M., Bruce-...
A systematic review was performed to evaluate the effectiveness of nutrition as a standalone countermeasure to ameliorate the physiological adaptations of the musculoskeletal and cardiopulmonary systems associated with prolonged exposure to microgravity. A search strategy was developed to find all astronaut or human space flight bed rest simulation...
Introduction
Exercise with the Functional Re-adaptive Exercise Device (FRED) has previously been shown to activate the lumbar multifidus (LM) and transversus abdominis (TrA) muscles in non-symptomatic volunteers. This study aimed to determine the effects of a six-week FRED exercise intervention on pain intensity, patient-reported function and LM cr...
This document is intended to guide potential reviewers through the process of conducting a qualitative systematic review. You are advised to use this as a basic overview of the key steps and to supplement (not replace) gold standard qualitative systematic review methods provided by PRISMA and Cochrane. It should be noted that there are times at pre...
Reduced paraspinal muscle size and flattening of spinal curvatures have been documented after spaceflight. Assessment of trunk adaptations to hypogravity can contribute to development of specific countermeasures. In this study, parabolic flights were used to investigate spinal curvature and muscle responses to hypogravity. Data from five trials at...
This tool provides a list of potentially relevant sources to find trials, qualitative data and grey literature relevant to aerospace medicine systematic reviews. It is not an exhaustive list and review authors should beware that data may well exist with agency databases or be classified. It is advised to search all data sources you think may be rel...
Introduction
Interventions to promote daily physical activity are becoming important in the management of patients with COPD due to significantly lower levels of physical activity compared to healthy age-matched controls [1]. To-date inconsistent findings surrounding the implementation of physical activity promotion and the way pedometers are used...
The aim of this study was to examine the use of pedometers as a tool to promote daily physical activity levels in patients with COPD.
A systematic review meta-analysis of pedometer physical activity promotion in patients with COPD was conducted. Medline/PubMed, Cochrane Library, Web of Science and CINAHL were searched from inception to January 2019...
Find the most up to date methods here: https://sites.google.com/view/sr-methods/home
Mechanistic studies of the Functional Re-adaptive Exercise Device (FRED) have shown it automatically recruits Lumbar Multifidus (LM) and Transversus Abdominis (TrA) – two deep-spinal muscles that are atrophied and show altered motor control in low back pain (LBP). No studies have investigated the time required to familiarise to FRED exercise, which...
Musculoskeletal loss in actual or simulated microgravity occurs at a high rate. Bed rest studies are a reliable ground-based spaceflight analogue that allow for direct comparison of intervention and control participants. The aim of this review was to investigate the impact of exercise compared to no intervention on bone mineral density (BMD) and mu...
Find the most up to date version here: https://sites.google.com/view/sr-methods/home
This tool is concerned with scoring the quality of non-empirical data sources (e.g. technical documents, non-experimental documents and/or documents not published in academic journals).
Find the most up to date version here: https://sites.google.com/view/sr-methods/home
This is a spreadsheet that you can use to manage study information during reviews. tI is setup for bed rest studies and includes a section for our bed rest quality scoring tool. However, it can be adapted for a range of different tools and reviews. The current ver...
Introduction
Evidence based practice requires showing upon what we are basing medical opinions and guidelines, or recognising when evidence is absent that guidance is “expert opinion” and research is required to fill evidence gaps. Aerospace is one of the final medical fields to begin organising a critical summary, adapted periodically, of evidence...
The European Space Agency has recently announced to progress from low Earth orbit missions on the International Space Station to other mission scenarios such as exploration of the Moon or Mars. Therefore, the Moon is considered to be the next likely target for European human space explorations. Compared to microgravity (μg), only very little is kno...
Cardiopulmonary changes in Martian gravity.
Biomechanical changes in Lunar gravity.
Biomechanical changes in Martian gravity.
Biomechanical changes in 0.25 g.
Cardiopulmonary changes in 0.25 g.
Cardiopulmonary changes in Lunar gravity.
Purpose:
Lumbar multifidus (LM) and transversus abdominis (TrA) show altered motor control, and LM is atrophied, in people with low-back pain (LBP). The Functional Re-adaptive Exercise Device (FRED) involves cyclical lower-limb movement against minimal resistance in an upright posture. It has been shown to recruit LM and TrA automatically, and may...
Find the most up to date version here: https://sites.google.com/view/sr-methods/home
This tool is concerned with rating the quality and indirectness of bed rest studies being used to simulate human space flight. If used please contact us at A.Winnard@northumbria.ac.uk so we can track the tool’s use and cite as Winnard A, Nasser M (2017) AMSRG tool...
Find the most up to date version here: https://sites.google.com/view/sr-methods/home
This form can be used as is, or as a guide for your own form. It is based on the forms used by Cochrane Groups, so conforms to high standards from medical research. Specifically the form will help your work to meet Methodological Expectations of Cochrane Intervent...
Find the most up to date version here: https://sites.google.com/view/sr-methods/home
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Please beware that the link here is out of date. It may be dangerous to continue using out of date methods. Find the latest methods from experts you can trust here:
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Find the most up to date methods here: https://sites.google.com/view/sr-methods/home
This form is to help capture the nature of questions that are being refined to systematically review. Answers to the questions help form protocols for systematic reviews by guiding the determination of relevant populations, interventi...
Background:
Dysfunction of the lumbar multifidus (LM) and transversus abdominis (TrA) muscles is associated with low back pain (LBP). The Functional Re-adaptive Exercise Device (FRED) has shown potential as a non-specific LBP intervention by automatically recruiting LM and TrA. Loss or lordosis and altered lumbopelvic positioning has also been lin...
This tool is concerned with quantifying the effects of exercise countermeasures intended to prevent deconditioning (e.g. during periods of inactivity, bed rest, space flight).
Find the most up to date methods here: https://sites.google.com/view/sr-methods/home
This tool is concerned with rating the quality and indirectness of bed rest studies being used to simulate human space flight. If used please contact us at A.Winnard@northumbria.ac.uk so we can track the tool’s use and cite as Winnard A, Nasser M (2017) AMSRG tool for assessing bed rest methods. In: Winnard A, et al. 2016 Systematic Review of count...
Background:
No studies have been published on an astronaut population to assess the effectiveness of countermeasures for limiting physiological changes in the lumbopelvic region caused by microgravity exposure during spaceflight. However, several studies in this area have been done using spaceflight simulation via bed-rest. The purpose of this sys...
Oral presentation delivered at the European Congress on Physical and Rehabilitation Medicine
This report outlines the work undertaken by the ESA Post-Mission Exercise (Reconditioning) Topical Team to ascertain and provide details of evidence based postflight reconditioning programmes, looking beyond current practices in readiness for future longer duration missions. The report covers gaps in knowledge and proposes how terrestrial rehabilit...
Introduction Gravitational unloading of the spine during space flight and bed rest results in potentially injury inducing functional and morphological changes to the lumbopelvic muscles. In a series of studies we investigated the role of a Functional Re-adaptive Exercise Device (FRED) on the specific recruitment of local lumbopelvic muscles.
Projects
Projects (4)
Transparent, low bias and auditable review methods that enable global evidence based space medicine operations.
Find all the latest methods, advice and guidelines here: https://sites.google.com/view/sr-methods/home
The postural (or anti-gravity) muscles work to maintain stability of the musculoskeletal system during static and dynamic activities. When gravity is removed, these muscles reduce in size and their function becomes impaired. This musculoskeletal deconditioning can lead to increased risk of injury (e.g. low back pain), and it can be studied using a microgravity model (e.g. astronauts, long duration bed rest).
Since 2009, we have been investigating methods for preventing and/or rehabilitating from the musculoskeletal deconditioning seen following postural/anti-gravity muscle deconditioning. This research has developed from mechanistic, or "proof of concept", studies in injury-free participants and in people with low back pain, through to intervention studies (e.g. in low back pain). The key focus of this research has been the development of the Functional Re-adaptive Exercise Device (FRED) - a cyclical exercise device that targets the postural/antigravity muscles.
